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Computer Gaming Addiction Gaming Disorder Prevention and Treatment Treating Fire with Fire Kenneth Woog, BS EEE, MBA, Psy.D. Debra Woog, MA, LMFT, MPC Computer Addiction Treatment Program of Southern California computeraddictiontreatment.com Presentation: computergamingaddiction.com/treatingfirewithfire.pdf (c)2019 Kenneth M. Woog, Psy. D. 1 Gaming Disorder Prevention and Treatment Treating Fire with Fire Kenneth Woog, BS EEE, MBA, Psy.D. Computer Addiction Treatment Program of Southern California computeraddictiontreatment.com [email protected] (949) 422-4120 (c)2019 Kenneth M. Woog, Psy. D. 2 Gaming Disorder Prevention and Treatment Treating Fire with Fire Kenneth Woog, BS EEE, MBA, Psy.D. Other affiliations: Sentinel Gaming Systems, Partner Pepperdine University GSEP, PRYDE Program Director and Clinical Supervisor (c)2019 Kenneth M. Woog, Psy. D. 3 Gaming Disorder Prevention and Treatment Treating Fire with Fire Debra Woog, MA, LMFT, MPC Computer Addiction Treatment Program of Southern California computeraddictiontreatment.com [email protected] (949) 233-9058 (c)2019 Kenneth M. Woog, Psy. D. 4 Video Gaming Benefits* • Hand/eye coordination • Cognitive skills • Increased creativity • Spatial visual skills • Problem solving skills • Multitasking skills • Leadership /Teamwork • Socialization opportunities • Learning strategies • Improved mood * Not all games or game genres offer specific benefits (c)2019 Kenneth M. Woog, Psy. D. 5 Gaming Disorder ..too much of a good thing? * • Health Problems • Vision • Repetitive stress injuries • Disordered sleep/eating • Psychological Problems • Anxiety/depression • Gaming Disorder/Addiction • Cognitive fatigue • Truancies / Academic Failure • Reduced socialization Victoria Dunckley, MD: The Overstimulated Child: Physiology, Symptoms, and Reversal of Screen Time Impacts on Mental Health • Family / marital conflict Wednesday 8:15am * Not all games or game genres, result in these problems (c)2019 Kenneth M. Woog, Psy. D. 6 Gaming Disorder Prevention and Treatment Treating Fire with Fire (c)2019 Kenneth M. Woog, Psy. D. 7 Agenda • What is Gaming Disorder? Definitions • History of Videogame Addiction Research and Treatment • Use, prevalence and treatment surveys • Treatment outcome studies, challenges • Development of a harm reduction treatment model • Gaming Disorder research, diagnosis and treatment methods: 2019 • Developing a Gaming Addiction Treatment Model • Proposed Models of Videogame Addiction and Dependency • Theoretical functional analysis of treatment methods • Proposed treatment protocol • Supports both treatment and evaluation of outcomes • Case Studies • Prevention and Early Intervention • Informed From Research and Clinical Experience (c)2019 Kenneth M. Woog, Psy. D. 8 Trivia Question In what decade did the first legislation appear before the house of commons in Britain proposing the regulation of a very popular videogame, available for sale today, because of concerns young people were becoming addicted? 2010- 2019 2000-2009 1990-1999 1980-1989 1970-1979 (c)2019 Kenneth M. Woog, Psy. D. 9 1981 May 20, 1981, George Foulkes, MP, introduced a bill titled "Control of Space Invaders and Other Electronic Games." “That is what is happening to our young people. They play truant, miss meals, and give up other normal activity to play "space invaders". They become crazed, with eyes glazed, oblivious to everything around them, as they play the machines. It is difficult to appreciate unless one has seen it for oneself.” Walmart $299 (c)2019 Kenneth M. Woog, Psy. D. 10 Technology 1981 IBM PC 1-2 phones per household Space Shuttle Launch Atari 2600 Console (c)2019 Kenneth M. Woog, Psy. D. 11 38 Years Later: 2019 PS4 Xbox One iPotty (c)2019 Kenneth M. Woog, Psy. D. 12 Massive $150B Gaming Industry • Forecasted $250B by 2023 • Growing at 9-18% annually, huge growth in mobile gaming • Surpassed all other forms of entertainment DFC Intelligence 2019 (c)2019 Kenneth M. Woog, Psy. D. 13 Video Gaming Goes Pro • $100s of Millions Committed to League Play • Fierce Competition Between Top Gaming Companies • Streaming and television viewing income • eSports Leagues Now at High School and Colleges • College Scholarships Now Available • 16 y/o teen wins $3 million Fortnite Championship 2019! Problem: Games played and amount of play (hours) put players at risk of addiction and other health problems (c)2019 Kenneth M. Woog, Psy. D. 14 Rock Center Copyright© 2013 NBC Universal All Rights Reserved, Reproduced under Fair Use (Title 17: Chapter 1 § 107) 15 Gaming Disorder (aka Videogame Addiction) “a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences” World Health Organization (2019) (c)2019 Kenneth M. Woog, Psy. D. 16 Video Game Definition “A game in which you press buttons to control and move images on a screen.” (Oxford) (c)2019 Kenneth M. Woog, Psy. D. 17 Video Game Definition (2019) “Behavioral interventions designed using principles of psychology applied to individuals, often in groups, through electronics means with visual images, sound and user interaction. Commonly provided in exchange for financial compensation, the application of these interventions is intended to facilitate the stimulation of the mesolimbic dopamine (reward) pathways of the brain to enhance motivation for the repeated application of the interventions.” (Woog)* *Albeit cynical, even videogames designed as a therapeutic tool for treating physical and/or mental health conditions meet this definition (c)2019 Kenneth M. Woog, Psy. D. 18 Video Game Definition (2019) “Acceptable” to Gamers and Industry Electronic games you play alone or with friends That you buy and/or pay for indirectly through purchases in the game That are so fun that you want to play them a lot (c)2019 Kenneth M. Woog, Psy. D. 19 Video Games 2019 • Sophisticated behavioral interventions • Designed using principles of developmental, social and behavioral psychology • High user involvement through • Powerful sensory stimulation • Social involvement through significant personal relationships • High user involvement is very valuable financially - billions of dollars at stake • New business models require as much screen time as possible • Critical that users do not get satiated and change to different games • Highly competitive industry • Parents unable to monitor and or limit the delivery of these interventions • Delivered through a variety of devices that are difficult for parents to manage: Computers, laptops, tablets, game consoles, handheld gaming devices, cell phones • Parents may often give up trying • Excess use results in serious problems for users and their families • Health problems, psychiatric and psychological problems, academic, career and social problems including serious family conflict (c)2019 Kenneth M. Woog, Psy. D. 20 Problematic Gaming Research 1980s & 1990s • 1980s - Anecdotal reports emerging • Computer Addiction? Shotton, 1989 • Surveyed 127 teen/young adult males • Looked at all computing activities • Multi-user Dungeons and Dragons “…the MUD players hours were perhaps the most disruptive of their family lives than any other group” • 1990s Self report surveys • Fisher, Griffiths - Prevalence: 6% , 20% (c)2019 Kenneth M. Woog, Psy. D. 21 Problematic Gaming Research 2000s • Research Expanding Worldwide- 2.5-34% • 2005, 2007 Germany Grusser 15+y/o (n>7000) 9.3-11.9% • 2007 S. Korea. Lee & Han 5/6th graders (n=2584) 2.5% • 2007 Taiwan. Wan & Chiou 17-24 y/o (n=416) 34% • 2008 China. Xu & Yuan 13-18 y/o (n=623) 21.5% • 2009 Austria. Battrhyany 13-18 y/o (n=1068) 2.7% • 2009 Holland. Lemmens 12-18 y/o (721) 1.4-9.4% • 2009 US. Gentile 8-18 y/o (1178) 8.5% • Nationwide Harris Poll Online survey • Criteria similar to pathological gambling • Problems correlated to 25 hrs./week of game play • 2010 Australia. Thomas, Porter 14-54 y/o, 5-8% (c)2019 Kenneth M. Woog, Psy. D. 22 My First Gaming Disordered Clients: 2002 Coincidentally two 15 y/o males referred at about the same time • Client 1: Attempted to strangle mother with power cord when she unplugged the computer • Client 2: Had not been attending school for 3 months • Both: • Intact families, professional middle class, stay-at-home mothers • No history of mental illness or substance use disorders • No prior history of mental illness or behavior problems • No prior individual or family counseling • Both serious decline in academic performance • Both serious family conflict - child/parent, child/sibling and marital (c)2019 Kenneth M. Woog, Psy. D. 23 My First Gaming Disordered Clients: 2002 Initial Conceptualization: “Bad Parenting” • Parents had let this get out of control • Treatment: • Individual counseling: Not helpful, clients not interested in counseling • Family/Parent counseling and behavioral contracting • Both able to work around parental controls • Cycles of removing / returning the computer created more problems • Medication: Both placed on SSRIs: ineffective • Suicidality: Both hospitalized • Reconceptualization: Addiction? • Internet / Gaming Addiction was controversial, limited research • Decided to conduct my own research on what this was and how it could be treated (c)2019 Kenneth M. Woog, Psy. D. 24 MMORPG Social Psychology Research Everquest - Nick Yee (2002) Yee, 2002 (c)2019 Kenneth M.
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